Everything You Need to Know About CAM
1. The Imperfections of real medicine do not validate your kooky theories.
You, oh purveyor of snake oil, may exhaust yourself pointing out the flaws in medical science. You may grimly list the horrific side effects of many of our therapies and gleefully highlight the lack of evidence for quite a few things done in the real medical world. You may even solemnly condemn our general inability to really cure much of anything but, apart from making yourself really tired and giving me a crick in my neck from nodding in agreement, all you will have demonstrated is that real medicine is an imperfect business which is not a huge revelation to anyone who has spent more than an hour in a nursing home, a hospital, or any other place where you can find incredibly sick people who, despite our best efforts, often remain incredibly sick and die after being flogged by the mightiest weapons in the medical armatorium. A darn shame but it does not follow that the solution to our limited medical knowledge is pixie dust, magical gnomes, or spiritual energy streaming from your fingertips.
On the other hand, while medicine is imperfect you'd have to be a ***** or totally brainwashed into your particular CAM cult to not recognize the tremendous advances in medicine even over the last twenty years to say nothing of the huge leap from the days of snake oil at the turn of the last century. That's the point of modern medicine. It advances. Expanding knowledge leads to to increasingly sophisticated and effective therapies. It's Complementary and Alternative Medicine that is perfect. Everything you need to know about acupuncture for example, was elucidated a thousand years ago well before those wily Chinese had even the foggiest notion about germs or cardiac physiology. They so totally nailed it that no new research needs to be done. It's all about qi and the meridians along which it happily flows and is so perfect as to be impervious to debate, refutation, or criticism. While we plod along with our feeble attempts to expand medical knowledge acupuncurists ply their needles in service of a perfect medical philosophy that was ossified in the Dark Ages.
2. The complexity of your kooky theory does not validate it.
For thousands of years Astrology was considered a legitimate science and the best minds of those distant ages devoted their lives to deriving horoscopes and divining the effects of the stars on our lives. They wrote books, developed complicated theories, and tried to apply the principles of Astrology in every aspect of life including medicine. And yet today if you proposed endowing a Chair of Astrology at your Alma Mater or incorporated horoscopes in your medical practice I have no doubt that even the most laissez-faire of liberal academics, grimly keeping their minds open in the face of every other stupidity under the sun, would at last have their fill and laugh in your face with all the pent-up rage of a politically correct bureaucrat forced to shuck and jive to ideas he knows to be ridiculous. Clearly astrology is ridiculous despite the vast amounts of intellectual energy that have been (and still are) devoted to it.
In the same vein, I have no doubt that Ayurvedic Medicine has been beaten to death by the learned men of India for thousands of years in the same manner that Astrology was dissected in the West. I also have no doubt that there is a massive body of Ayurvedic scholarship collecting dust in libraries from Duluth to Calcutta. But as it's a system of medicine based on a highly imperfect understanding of physiology, more religious than scientific, and Indians who used it pretty much dropped like flies from diseases that it took Western medicine to defeat, except for historical interest all of that intellectual activity is as useless as trying to divine the future from the entrails of birds. You can learn Sanskrit to really get into the source material but you're wasting your time. The initial premise is wrong and, like a house built on weak foundation, no matter how much you spend on the bathrooms it's still going to collapse.
3. Complementary and Alternative Medicine is parasitic, not symbiotic.
Suppose I were to actually build a house. Along with a foundation it would require framing of the walls and floors, siding, wiring, glazing, plumbing and a dozen other skilled trades coordinating their efforts. The practitioners of Complementary and Alternative Medicine would be like your Aunt Mildred telling you how to hang the toilet paper in the finished bathrooms and then trying to claim credit as an essential part in the construction. Complementary and alternative medicine only exists because real medicine does all of the heavy lifting leaving a risk-free environment in which it may ply its patent remedies. At best it's an afterthought, something that legitimate hospitals add to their services to attract the kook money. At worst it's a cynical ploy to fleece a little extra from the desperate, many of whom are dying and will gladly pay for another straw to grasp. In no way is it an essential part of medical therapy except that it provides entertainment to the patients and their families while medicine and nature run their courses.
4. Placebo Medicine is not Medicine.
Millions of dollars are wasted every year on shoddily constructed studies trying to demonstrate efficacy of Complementary and Alternative Medicine. The results have been disappointing and entirely predictable. Generally, if you ignore poor study design and spin the data just so, CAM is shown to be occasionally but not reliably slightly, and we're talking slightly, more effective than placebo. These results are naturally touted as a both a huge victory for kook-dom and as a justification for continuing to charge large sums of money for therapies that are so close to placebo in their effectiveness that you should wonder why the opposite conclusion isn't derived. In other words, maybe if your treatment modality is so iffy, requiring as it does to be viewed through squinted eyes in dim light at a distance of several hundred feet to show even a trace of effectiveness, maybe you need to reassess your career goals. Call me a cynic but something that is slightly better than placebo could also be called next to useless. Certainly not worth spending a lot of money on unless it carries a big disclaimer saying, "For Entertainment Purposes Only."
5. You Can be Fooled
I'm a fairly intelligent guy Not a super-genius or anything like that but I can tease out the truth of most things if given enough time and, when the wind is just right, can tell a hawk from a handsaw. And yet I am not so confident in my intelligence that I don't think I can be fooled. Because, for example, I having nothing but a polite interest in automotive technology I am pretty much at the mercy of my mechanic when he describes the repairs needed by our aging pair of automobiles. I trust the guy because nothing he has ever suggested sounds too outrageous and on a couple of occasions he replaced a three-dollar fuse when he could have taken me for an alternator. I am however at his mercy unless I want to study car repair or haul the thing to more than one mechanic.
Consider the typical customer of Complementary and Alternative Medicine. They are usually fairly intelligent and, by necessity, prosperous enough to pay for something as exotic as a Chakra tuning. But as far as medical knowledge? Not even a clue except for some superficial things and the usual lies and half-truths they have found on the internet. Medicine is an order of magnitude more complicated than auto-repair (although a good mechanic, like a good barber, is worth his weight in platinum) and cannot be casually learned by most people. I can read about engines and have enough of an understanding of their workings to understand what my mechanic is telling me but compared to learning the necessary background to diagnose, treat, and manage disease, this does not require too much effort. When it comes to medicine, the public who undeniably have a huge interest in the subject naturally gravitate towards explanations that simplify things a tad and don't require quite the intensive science background.
It's just human nature. We prefer the simple explanations that do not require complicated and often non-linear thinking. Acupuncture, for example, is billed as redirecting the flow of mystical energy in the body by the use of needles. It jibes pretty well with what most people learned watching those poorly animated Saturday morning cartoons where, instead of incurring the expense of animating the characters, every important action is mediated by some kind of force field or power ray shooting out of Captain Planet's hands. Thus there is a natural tendency of the public to accept Acupuncture, seeing as it jibes with their world-view. Or consider Homeopathy whose founding principle, that like cures like, is not only appealing to the ear and the heart but also sounds strangely like some of the dim knowledge the public has about the action of vaccines. If they had a more detailed understanding of the immune system it wouldn't sound so good but who has the time to read a boring old immunology textbook when American Idol is down to the final four?
Intelligent as they are I have to laugh at the typical consumer of Complementary and Alternative Medicine who, while open-minded to a fault, deride speaking in tongues, Christian faith healing, and other barbaric customs of the uncouth rubes infesting the backwoods but pay good money to have some charlatan extract bad Chakra. The difference between some sweaty little televangelist and your local purveyor of Complementary and Alternative Medicine is nothing but style and body mass index and you are being robbed just as surely as if you are sending money for prayer intercession to the Reverend Jimmy Swaggert. You can be fooled, especially when it comes to religion. What, after all, is the standard orthodoxy of open-mindedness, non-judgmentalism, and self-absorption but a religion? It preaches that belief is a substitute for reality and that to even question its central belief, that self-created reality trumps the real kind, is to be an infidel.
The denizen of a mouldering single-wide trailer in Sisterboff, Arkansas sending money to an oily television preacher so Jesus can reveal the winning lottery numbers is philosophically no different than a fit, professional woman swallowing her homeopathic remedies. One has a faith in her dimly understood religion, the other in her poorly understood notion of science. Both are being played for suckers.
6. Quantum Physics, The Last Refuge of Scoundrels
Quantum physics describes the relationships between energy and matter at the subatomic level where the principles of classical physics (momentum, acceleration, velocity, etc.) do not apply. In particular it addresses the relationship between the orbital shells of electrons and photons. It is not a goofy, mystical endeavor that exists outside the realm of the rational world and in fact, while classical physics cannot explain quantum phenomena, quantum physics explains classical physics which results from the cumulative effects of quantum properties.
Quantum mechanics no more explains Reiki, Homeopathy, or Acupuncture than do magic pixies. Or to put it another way, if you were to posit quantum effects as a mechanism for your particular quackery du jour as is common among the purveyors of complementary and alternative medicine you may as well use it to bolster your belief in just about anything at all, no matter how ridiculous. To be sure the field of quantum physics is expanding and there is much to be learned. But it is not expanding towards Ayurvedic Medicine or Homeopathy. Physicists are hard at work trying to reconcile quantum physics with relativity, not proving the existence of Chakra. So sorry. Like I said, you can be fooled and your Homeopath desperately clinging to quantum theory knows less about it than he does about medicine. It's just part of the con; his attempt to mix enough scientific chatter into a his otherwise nonsensical duckspeak so you will buy it.
7. Political Correctness Does Not Apply to Medicine
The ancient Chinese did not have advanced medical knowledge which allowed them to live long, healthy lives. And they did not, as has been suggested, have diseases unique to their own culture against which their indigenous medicine was effective but which does not work against the white man's diseases. It is probably true that the Han Dynasty Chinese did not have too much colon cancer, for example, but then the average lifespan back then was around thirty and to live past sixty represented either an exceptionally privileged or lucky life. I am 43 and I have no health problems nor have I ever had any. But let's see how I do in another twenty years when all of those bacon and eggs have had a chance to work their magic. Who knows what diseases I will get? Whatever they are they will all be the sequelae of a life lived well beyond genetic usefulness and this potential smorgasbord of morbidity is only to be made possible because Western medicine can extend my life long enough for it to happen. In ancient China (or Europe, or Meso-American, or Africa) I would have been dead or decrepit by now and my predictable decline would have been ascribed to old age or maybe Utapu, the God of Rectal Fire. Not only that but the disease that finished me would have been poorly decribed and my long life into the forties would be testimony to the benefits of keeping my qi in order.
This is not to say that the ancients didn't occasionally stumble upon some legitimate medicine. Surgeons for the Roman Legions, for example, used silver staples to close wounds no doubt having observed that silver had some antiseptic properties. But they still had no idea of germ theory so anybody who would prefer the Legion's medicus vulnerarius over a modern trauma surgeon is an idiot.
Political correctness is an apologia by the guilt-ridden children of the baby-boomers for the current but by no means permanent economic, political, scientific, and military superiority of the West. It is an angst-ridden, completely irrational philosophy that has as its central theme that only Western man has ever behaved in a violent, selfish, or self-destructive manner. It constructs an artificial worldview and is an insubstantatial foundation on which to anchor medicine, a science which like all practical endeavors should be as rational as possible.
8.You Can't Have it Both Ways
I have some fundamentalist Christian relatives who believe the Bible to be a literal account of the creation of the world. They're not wishy-washy Christians who get all mushy around the edges and, in an effort to reconcile science and their weak faith, allow that perhaps "a day to God is a billion years to the rest of us." The Bible says the world was created in six days and by golly, it was created in six 24-hour days. God said it. They believe it. If you don't you're going to hell. Paleontology? Evolution? The fossil record? All tricks of the Deceiver to lead the faithful astray.
You may think that I dislike people who hold these beliefs, or that I am bothered by what I can only call their profound ignorance, but you would be wrong. I admire their faith and they are as welcome to it as anybody else is to theirs. I'll even send my kids to one of their private schools if I have the chance because learning math, reading, and writing (something not emphasized in many public schools as they are in the grip of their own peculiar religion) is not strictly dependent on a belief in evolution and we can always do a little deprogramming when they get home.
On the other hand I often find myself in goofy conversations (wrestling with pigs if you know the analogy) where my relatives insist that paleontology is bunk because Carbon-14 dating, apart from being a tool of the Devil, is wildly inaccurate and cannot establish the age of ancient fossils. A little later in the conversation we usually roll around to how someone has found the Ark, a barn-like structure on a mountain in Turkey, that has been positively Carbon-14 dated to the time of Noah. I am not a smart guy and I struggle, yes struggle, with sophisticated intellectual concepts but even I can see the contradiction here, the blatant doublethink required to both believe and at the same time disbelieve something depending on what you are trying to prove.
In much the same manner do the True Believers of Complementary and Alternative Medicine try to eat the proverbial cake and have it, too. The NIH, they proudly point out, studies CAM using the same methods used to study real science. Not only does this establish the validity of quackery in their minds but the very act of a government agency studying their peculiar little beliefs is an act of validation in itself. And yet, when numerous well-designed studies using rigorous statistical methods continue to show that Complementary and Alternative Medicine is nothing more than an expensive and highly detailed placebo, the usual accusations are made that the scientific method is inadequate to study qi or spiritual fire shooting from the appendages of the healer. The current meme of the homeopaths, for example, is that independent research of homeopathy is impossible because, through some quantum effect, the beliefs of the investigator influence the actual efficacy of homeopathic remedies. In other words, only a homeopath who believes in homeopathy can research homeopathic effects.
Which then, is it? Is your particular flavor of quackery a scientifically verifiable treatment modality or is it a religion whose secrets are only available to those who make the leap of faith required to believe it? You can't have it both ways. If you would enter the arena of science then you have to face the lions.
9. You are not the Pope.
I mean, seriously now. Let's suppose, for the sake of the argument, that there is spiritual fire that can be channeled from your appendages to cure disease. What makes you think some greasy little sociology major who sat through a couple of motivational seminars is the one who can do it? The Pope, for his part, is the spiritual leader of the world's one billion Catholics, a deeply pious and theologically sophisticated man, and yet he would be the first to deny that he can work the kind of miracles that are the regular activity of oleagenous Pentacostal preachers and their svelte, holistic counterparts in the alternative medicine world. In other words, how do you verify the claims of your dime-store miracle workers? Has your Reiki healer graduated at the top of his class in Lahore or did he go to a cut-rate Reiki training course in Klamath Falls? How do you know your homeopath is shaking the mixture the right way? If there are several schools of acupuncture with their own meridians (and there are), who's nailing qi like a big dog and who's just jabbing you with needles? The fact that many of you don't even think to ask these questions but accept every smooth-talking healer as the real McCoy indicates a level of gullibility, already incredible, that should be embarrassing for any adult who purports to have any street-smarts.
10. "Holistic" is a marketing phrase.
When confronted by the evidence, the purveyors of Complementary and Alternative Medicine will fight a desperate rear-guard action as they retreat deeper into the interior of their vast, irrational country. Finally, in a last-ditch effort to hold onto even that infertile territory they will rally around the holistic banner, insisting that Complementary and Alternative Medicine treats the whole patient while real medicine does not. If you think about it however, it is real medicine, a profession with both generalists and specialists that is treating the whole patient or at least the important, non-entertaining parts. This is why there are so very few Reiki healers doing critical care medicine. Namely because the whole patient is an order of magnitude more complex than can be handled by what is essentially the entertainment committee. Cardiovascular collapse? Sepsis? Rectal bleeding? Please, they're too busy managing how the patient feels to be bothered with objective disease.
If there's one thing I'd like every medical student to unlearn its the supposed significance of the term "holistic." It's just a word like "granola," a clever marketing phrase which is used to disguise a bunch of unwholesome things. When I hear the word "holistic" I reach for my revolver.
, must not have been very thorough after all.
Irony at its finest.
